Klinicheskaia Meditsina[JOURNAL]
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200 papers
[Clinical manifestations of antiphospholipid syndrome associated with lesions of the central nervous system].
Budnevskiy AV, Kutashov VA, Kravchenko AY
Klin Med (Mosk) · 2016 · PMID 30289654
Antiphospholipid syndrome (APS) is one of the important but poorly known conditions. Its symptoms are ofparticular interest for neurologists since thrombi are most often localized in the cerebral blood vessels which lead...
Antiphospholipid syndrome (APS) is one of the important but poorly known conditions. Its symptoms are ofparticular interest for neurologists since thrombi are most often localized in the cerebral blood vessels which leads to ischemic cerebrovascular accidents (AICS). APS can also manifest itself in the following symptoms: epileptic attacks, dementia, headache, chorea, peripheral neuropathy, myelo- and encephalopathy phenomenologically similar to multiple sclerosis. This article presents a clinical case of secondary APS with the neurological manifestations in a 25-year-old female patient.
[Hepatic tuberculosis with the development of fibrosis and concomitant steatohepatitis].
Esedov EM, Shakhnazarov AM, Abasovs AS … +4 more , Medzhidova RA, Akhmedova FD, Muradova VR, Magomedeminova SR
Klin Med (Mosk) · 2016 · PMID 30289653
Tuberculous lesions of the liver frequently occur in autopsy material, even though most of them are clinically unapparent. Pathogenetically, hepatic tuberculosis is a manifestation of general military tuberculosis with t...
Tuberculous lesions of the liver frequently occur in autopsy material, even though most of them are clinically unapparent. Pathogenetically, hepatic tuberculosis is a manifestation of general military tuberculosis with the infection brought in through the hematogenous route (through the hepatic artery or the portal system) as a result of intestinal or mesenteric lymph node tuberculosis. We report a case of combination of hepatic tuberculosis and diabetes mellitus in a young woman with reference to the clinical course of the disease, its diagnostics and treatment.
[New anticoagulants in clinical practice. Effectiveness and problems].
Bokarev IN, Kondrat'eva TB
Klin Med (Mosk) · 2016 · PMID 30289652
We analyze the effectiveness of new oral anticoagulants and antivitamins K for the treatment of patients with venous problems, atrial fibrillation, and acute coronary syndrome with reference to advantages of this therapy...
We analyze the effectiveness of new oral anticoagulants and antivitamins K for the treatment of patients with venous problems, atrial fibrillation, and acute coronary syndrome with reference to advantages of this therapy and methods of prevention of complications of these conditions.
[HLA-DR expression on monocytes as a prognostic criterion for the development of pyoinflammatory processes at various stages of surgical treatment].
Chepeleva MV
Klin Med (Mosk) · 2016 · PMID 30289651
We studied relative content of CD14+HLA-DR in 214 patients including those with aseptic instability and stable implants of the knee and the hip, periprosthetic infection of the hip, chronic posttraumatic osteomyelitis of...
We studied relative content of CD14+HLA-DR in 214 patients including those with aseptic instability and stable implants of the knee and the hip, periprosthetic infection of the hip, chronic posttraumatic osteomyelitis of long tubular bones, and osteomyelitis generalization (sepsis). We determined HLA-DR expression on monocytes by laser flow cytofluorometry using Beckman Coulter Epics XL (USA) cytometer and monoclonal antibodies (Immunotech Company, France). It has been demonstrated, that the decrease in HLA-DR expression on monocytes can be one of the mechanisms of increasing immune disorders in patients with orthopedic pathology and monitoring HLA-DR monocytic expression can be used as a prognostic criterion of developing pyoinflammatory processes at the stages of surgical treatment.
[Respiratory sleep disorders in vehicle drivers].
Elgarov AA, Kalmykova MA, Elgarov MA
Klin Med (Mosk) · 2016 · PMID 30289650
AIM: To determine the frequency of respiratory sleep disorders (RSD) in vehicle drivers, peculiarities of their clinical status and workability. MATERIAL AND METHODS: The study included the main group of 106 vehicle driv...
AIM: To determine the frequency of respiratory sleep disorders (RSD) in vehicle drivers, peculiarities of their clinical status and workability. MATERIAL AND METHODS: The study included the main group of 106 vehicle drivers (VD) and control group of 104 of subjects of other professions. The following methods were used: fibrooptic endoscopy, standard questionnaire, pulsoxymetry, 24 hour blood pressure and ECG monitoring, psychophysiological testing of 86 VD with RSD, arterial hypertension with and without complications. RESULTS: The clinical and instrumental signs of RSD were found in 65.1% VD of the main group and 47,1% of controls. Transitory ischemic attacks, cardiac arrhythmias and their combination occurred more frequently in VD (82.6, 59.2, and 52.2% respectively) than in controls (51.0, 44.8, and 32.6%). In most observations of VD, the smoking rate (98.1%), alcohol intake (95.3%), increased body mass (74.5%), obese (21,7%) dyslypoproteidemia (73.6%), left ventricular hypertrophy (54.7%) and arterial hypertension (57.5%) were significantly higher than in controls : S (76.9%), AI (75.0%), IBM (56.7%), O (18.3%), DLP (59.6%), LVH (41.3%), AH (39.4%). Chronic obstructive pulmonary diseases was diagnosed in 55.6% of VD and 51.9% of controls, diabetes mellitus in 34.9% and 20.2%, epidemiological forms of ischemic heart disease in 22.6% VD and 20.2% controls. Psychophysilogical testing of VD group revealed deterioration of professional qualities and functions of the drivers with respiratory sleep disorders. CONCLUSION: Significant frequency of RSD among VD (65.1%) in comparison with subjects of other professions (47.1%) was documented. RSD cause deterioration ofprofessional abilities of VD which increases the risk of traffic accidents.
[Pulmonary function in patients with type 2 diabetes and coronary artery disease].
Bazdyrev ED, Polikutina OM, Kalichenko NA … +2 more , Slepynina YS, Barbarash OL
Klin Med (Mosk) · 2016 · PMID 30289649
UNLABELLED: Currently, there is no convincing evidence of respiratory failure in patients with diabetes mellitus (DM) and coronary artery disease (CAD). Aim: To evaluate the differences in the main parameters of pulmonar...
UNLABELLED: Currently, there is no convincing evidence of respiratory failure in patients with diabetes mellitus (DM) and coronary artery disease (CAD). Aim: To evaluate the differences in the main parameters of pulmonary function in patients with isolated type 2 diabetes and diabetic patients with CAD. MATERIALS AND METHODS: Patients with diabetes were allocated to two groups depending to the presence of CAD. The assessment of carbohydrate and lipid metabolism, as well as the measurement of inflammatory markers were performed using standard methods of clinical and biochemical analysis. Respiratory function and diffusion capacity of the lungs (DLCO) were assessed using a body plethysmograph Elite Dl-220v. RESULTS: Main pulmonary functional test parameters were within normal values, except residual volume in diabetic patients. Patients with concomitant CAD demonstrated lower values of the studied parameters compared to non-diabetic ones. A number of volume and flow rate parameters as well as DLCO correlated with systemic inflammation, decompensation of carbohydrate and lipid metabolism, and duration of diabetes. CONCLUSION: Diabetic patients with CAD suffered from respiratory failure, manifested as decline in pulmonary function and DLCO. Blood glucose levels, inflammation symptoms, dyslipidemia and myocardial dysfunction are among suspected causes contributing to the development and acceleration of this decline.
[Diurnal rhythm of arterial pressure in patients with acromegaly].
Zav’yalova YV, Borovkov NN, Dulin PA … +3 more , Borovkova NY, Zanozina OV, Simonenko AV
Klin Med (Mosk) · 2016 · PMID 30289648
24 hr monitoring of arterial pressure (AP) in 46 patients with acromegaly in active phase revealed systolic-diastolic arterial hypertension. Analysis of diurnal profile showed the absence of the normal nocturnal fall in...
24 hr monitoring of arterial pressure (AP) in 46 patients with acromegaly in active phase revealed systolic-diastolic arterial hypertension. Analysis of diurnal profile showed the absence of the normal nocturnal fall in AP (non-dipper profile) and the significant rise in the number of patients with elevated nocturnal AP (night-peakers).
[The prognostic value of transient arterial hypertension in patients with chronic heart insufficiency and preserved left ventricular ejection function].
Klin Med (Mosk) · 2016 · PMID 30289647
UNLABELLED: There is a J-like dependence of mortality among patients with chronic heart insufficiency (CHI) on arterial pressure (AP). This implies the possibility of not only elevation but also fall of AP in such patien...
UNLABELLED: There is a J-like dependence of mortality among patients with chronic heart insufficiency (CHI) on arterial pressure (AP). This implies the possibility of not only elevation but also fall of AP in such patients. The aim of the study was to determine the frequency and prognostic value of arterial hypotension episodes in CHI patients with preserved left ventricular ejection function (CHI-PEF). . MATERIALS AND METHODS: The study included 169patients (74 men and 95 women) with CHI (mean age 56,3±10,9 yr). All of them had PEF higher than 50%. 105 patients had FCII CHI, 64 ones FCIII CHI. Stage IIA was documented in 136 and stage IIB in 33 patients. Duration of the study 24 months. The combined end point included non-fatal myocardial infarction and cardiovascular death. RESULTS: Arterial hypotension at office AP was diagnosed in 16 (9,5%) patients, transient arterial hypotension based at 24 hr AP monitoring in 104 (61,6%) patients. A total of 8 combined end points were documented during the study period. All these patients had transient systole-diastolic and/or systolic arterial hypotension . No myocardial infarction or lethal outcome developed in CHI patients without episodes of arterial hypotension (x=4,28, р=0,04). CONCLUSION: 24 hr AP monitoring in CHI-PEF patients permits to significantly increase the frequency of detection ofpotentially dangerous changes of AP. Transient arterial pressure occurs in 61.6% of the FCII-III CHI-PEF patients. Transient systole-diastolic arterial hypotension significantly increases the risk of non-fatal myocardial infarction and cardiovascular death in CHI-PEF patients
[ABO and RHD blood types distribution of the patients treated in the Federal Center of Cardiovascular Surgery of Krasnoyarsk].
Makovskiy AA, Popov AA, Gysev SD … +1 more , Barhatova LI
Klin Med (Mosk) · 2016 · PMID 30289646
The knowledge of blood types frequency in hospital patients helps to plan and perform transfusion therapy at blood donor centers. The distribution of patients’ blood by ABO groups and RhD allows to more efficiently organ...
The knowledge of blood types frequency in hospital patients helps to plan and perform transfusion therapy at blood donor centers. The distribution of patients’ blood by ABO groups and RhD allows to more efficiently organize and use donor blood banks. The risk of a disease is related to genome composition and is inherited with an ABO blood type. Every person should know his (her) ABO blood type and RhD to enable early identification of the first symptoms of an illness. Materials and methods. This work is based on the study of 4831 blood samples from patients treated at the Center of Cardiovascular Surgery in 2013 (2885 (59,7%) men of the mean age 55 years and 1946 (40,3 %) women of the mean age 57 years). Results. Type A blood occurred most frequently (1787 or 37,0% samples) followed by group O (1625 or 33,6% samples). Samples of group B made up 1025 of the total (21,2%), AB blood group was found in 394 samples (8,2%). Conclusion. The blood types distribution of the ABO system in the patients treated at the Center of Cardiovascular Surgery was characterized by the following pattern: A > O > B > AB. Group A was identified in 37,0% of the patients. Its frequency is similar to that in the population of the western part of Russia and Moscow but different from that in the people living in nearby regions. The frequency of RhD system antigens is comparable in all regions of Russia. CcDEe, ccDEe, CcDee, CCDee are considered to be the most widespread phenotypes. The residents of the Krasnoyarsk region and some nearby regions having blood type A apply to the Center of Cardiovascular Surgery with cardiovascular disorders more frequently than those with others ABO blood types.
[The strategy for the surgical treatment of femoral fractures in polytrauma].
Shapkin YG, Seliverstov PA
Klin Med (Mosk) · 2016 · PMID 30289645
The review describes peculiarities of the choice of time and methods of osteosynthesis offemur fractures of different localization in patients with multiple injuries in accordance with modern concepts of treatment of sev...
The review describes peculiarities of the choice of time and methods of osteosynthesis offemur fractures of different localization in patients with multiple injuries in accordance with modern concepts of treatment of severe multiple and associated lesions. Analysis of domestic and foreign literature shows that earlyfixation of the femur in case of polytrauma can reduce the mortality rate associated with complications and improve the functional outcome. Terms of osteosynthesis of the femur in polytrauma should be chosen taking into account the severity of the injury, the patient's condition, and the period of traumatic disease. The procedure of osteosynthesis must not be a threat to the clinical condition. The choice of the method for fixation of the femur depends of fracture type and location, the presence of fractures in the adjacent and remote segments. The minimally invasive techniques of osteosynthesis of the femur and staged surgical treatment of the victims in an unstable state should be chosen for the treatment of multiple injury in accordance with the concept of «Damage Control Orthopedics».
[The use of reamberin in combined intensive care of acute poisoning].
Livanov GA, Lodyagin AN, Batotsyrenov BV … +3 more , Loladze AT, Glushkov SI, Kovalenko AL
Klin Med (Mosk) · 2016 · PMID 30289644
This review is focused on the substrate antihypoxant reamberin used in intensive therapy of acute poisoning with special reference to the mechanisms of its action consisting in the reduction of the severity of metabolic...
This review is focused on the substrate antihypoxant reamberin used in intensive therapy of acute poisoning with special reference to the mechanisms of its action consisting in the reduction of the severity of metabolic disorders manifested as a decrease of tissue hypoxia, recovery of antioxidant defense and suppression of the activity of lipid peroxidation and endotoxicosis. The antihyhypoxant activity of reamberin is apparent as the reduction of the hypoxic brain lesions in patients with acute poisoning which leads to a significant improvement in the clinical course of acute poisoning and decreases the number of adverse outcomes.
[Obesity: the modern view of a problem].
Achkasov EE, Rapoport SI, Runenko SD … +1 more , Razina AO
Klin Med (Mosk) · 2016 · PMID 30289643
The article is a review of recent epidemiological observations concerning the prevalence of overweight and obesity in different countries among people of different gender, age. social and ethnic groups. It also presents...
The article is a review of recent epidemiological observations concerning the prevalence of overweight and obesity in different countries among people of different gender, age. social and ethnic groups. It also presents and analyses health risks and comorbidities leading to disability and death as reported by domestic and foreign researchers. It was found that obesity has multifactorial pathogenesis directly related to energy balance, consumed and expended calories. The need of a multidisciplinary approach to the treatment and prevention of the disease is emphasized taking into consideration the influence of the environment and increasing urbanization on the development of the pathology as well as the role of government efforts to stimulate physical activity of the population in the framework of integral interdisciplinary programs and control over the quality of food. The priority areas for the correction of overweight include optimization of motor activity and diet correction.
[Atherogenesis in human - clinical aspects of circulating immune complexes].
Babintseva YD, Sergeeva AM, Karagodin VP … +1 more , Orekhov AN
Klin Med (Mosk) · 2016 · PMID 30289642
It has been suggested that circulating immune complexes containing low density lipoproteins (LDL-CIC) play a role in atherogenesis and are involved in the formation of early atherosclerotic lesions. The complexes, as wel...
It has been suggested that circulating immune complexes containing low density lipoproteins (LDL-CIC) play a role in atherogenesis and are involved in the formation of early atherosclerotic lesions. The complexes, as well as anti-LDL antibody were found in the blood of patients with atherosclerotic process in various cardiovascular diseases, well as in the blood of animals with experimentally modulated atherosclerosis. One can assume that the presence anti-LDL antibodies in blood is a result of an immune response that is induced by modification of lipoproteins. LDL-CIC differ from native LDL in many aspects. They have much lower levels of sialic acid, a smaller diameter and a higher density electronegativity than native LDL. The fraction of the LDL-CIC in serum is an important manifestation of the atherosclerotic process. LDL-CIC, unlike the native LDL is able to induce intracellular accumulation of neutral lipids, especially esterified cholesterol in cell cultures obtained from healthy human aortic intima and macrophages in culture. After removal of the LDL-CIC, the serum of CHD-patients loses its atherogenic properties. The titer of the LDL-CIC in the blood serum significantly correlate with the progression of atherosclerosis and in vivo has the highest diagnostic yield of measured among other lipid parameters. Increasing CIC- cholesterol could also increase the risk of coronary artery atherosclerosis.
[Cooperation with patients - guarantee of successful treatment].
Saperov VN
Klin Med (Mosk) · 2016 · PMID 30289223
The aim of the study was to substantiate the necessity of efficient therapeutic cooperation between the doctor and the patient. The main factors determining such cooperation are considered including odontological behavio...
The aim of the study was to substantiate the necessity of efficient therapeutic cooperation between the doctor and the patient. The main factors determining such cooperation are considered including odontological behaviour of the physician, the choice of the adequate treatment model, compliance with the principles and rules of medical ethics, deontological requirements regulating the patient/physician relationship. Special attention is given to such issues as the doctor’s authority, patient’s confidence, and professional preparation of the first patient’s visit. The authority of the physician depends on his professional skills and moral qualities, such as sense of duty, humanism, and love for his occupation. The causes behind failed relationships between the doctor and the patient are considered with special reference to deontological flaws on the part of the physician.
[Correction of oxidative stress in patients with chronic cerebral ischemia].
Goroshko OA, Novikov KN, Kukes VG … +5 more , Voeikov VL, Buravleva EV, Zhestovskaya AS, Berdnikova NG, Arkhipov VV
Klin Med (Mosk) · 2016 · PMID 30289222
A pilot study of the effect of the antioxidant drug ethylmethylhydroxypyridine malate on indicators of oxidative stress in patients with chronic cerebral ischemia. At 6 day course administration investigated the antioxid...
A pilot study of the effect of the antioxidant drug ethylmethylhydroxypyridine malate on indicators of oxidative stress in patients with chronic cerebral ischemia. At 6 day course administration investigated the antioxidant in these patients significantly accelerates the process of generation of superoxide anion radical, established by lucigenin-depended chemiluminescence that probably regulate a feedback mechanism oxidase systems. This increases the activity of superoxide dismutase, and reduced the concentration of secondary peroxidation product - malondialdehyde, making reasonable use of antioxidants in the treatment of this pathology.
[Comparative assessment of the effectiveness of treatment of pulmonary thromboembolism in elderly patients].
Medvedev AP, Deryabin RA, Nemirova SV … +2 more , Pichugin VV, Bokarev IN
Klin Med (Mosk) · 2016 · PMID 30289221
We compared the efficiency of treatment of 99 patientswith pulmonary thromboembolism using thrombolytic agents, surgical intervention, and anticoagulation therapy with heparin and vitamins K. The surgical treatment prove...
We compared the efficiency of treatment of 99 patientswith pulmonary thromboembolism using thrombolytic agents, surgical intervention, and anticoagulation therapy with heparin and vitamins K. The surgical treatment proved more efficient than the two other options.
[The significance of calprotectin for the evaluation of activity of inflammation in ulcerative colitis].
Nikitin AV, Matyukhin AA, Mordasova VI … +1 more , Latysheva MN
Klin Med (Mosk) · 2016 · PMID 30289220
The combination of clinical and instrumental methods with non-invasive markers of ulcerative colitis allows to predict the incidence of this disease and optimize conditions and quality of medical care. To-day, the use of...
The combination of clinical and instrumental methods with non-invasive markers of ulcerative colitis allows to predict the incidence of this disease and optimize conditions and quality of medical care. To-day, the use of non-invasive markers is a topical issuesince itprovidesa most informative screening test for the high-accuracydetermination ofresidual faecal calprotectin.
[Dynamics of cognitive disorders in patients with type 2 diabetes mellitus under effect of metabolic therapy].
Gatckikh IV, Petrova MM, Shalda TP … +3 more , Varygina EL, Kuznetsov MN, Narkevich AN
Klin Med (Mosk) · 2016 · PMID 30289219
The aim of this study was to investigate the efficiency of metabolic therapy in correction of cognitive impairment in patients with type 2 diabetes. We undertook the analysis of results of the treatment of cognitive dysf...
The aim of this study was to investigate the efficiency of metabolic therapy in correction of cognitive impairment in patients with type 2 diabetes. We undertook the analysis of results of the treatment of cognitive dysfunction in 80 patients with a diagnosis of type 2 diabetes. All patients received basic hypoglycemic therapy. 32 patients (study group) received in addition to the basal glucose lowering therapy daily intravenous infusion of 10 mlcytoflavindiluted in 200 ml of a 0.9% sodium chloride solution for 10 days, followed by 2 tablets b.i.d. for 25 days.The group of comparison consisted of 29 patients given in addition to the basal glucose-lowering therapy daily intravenous infusion of 24 ml (600 mg) thioctacid diluted in 200 mL of a 0.9% sodium chloride solution for 10 days. Thereafter, they received 1 tablet of thioctacid BV once daily for 30 days. The control group consisted of 19 patients who received basic hypoglycemic therapy without additional metabolic therapy.Inclusion of cytoflavin in the combined treatment of patients with type 2 diabetes ensured a more effective correction of cognitive impairment. There was a statistically significant improvement in optical-spatial activities (p = 0.001), attention (p = 0.001), abstract thinking (p = 0.046), and memory (p<0.001) compared to those in other groups, according to the MOS test. Positive dynamics was expressed as the improvement of the optical-spatial activities by 9,8 ± 10,3%, attention by 13,5 ± 11,8%, abstract thinking by 7,0 ± 8,9%, and memory by 23.0 ± 14 6%. The study of variations of the serum level of brain neurotrophic factor (BDNF) over time during the treatment with metabolic preparations reveal edits statistically significant increase (p = 0.002) in the patients treated with cytoflavin compared with comparison (p = 0.139) and control (p = 0.078) groups. These results suggest the influence of cytoflavin on the processes of neuroplasticity under conditions of hyperglycemia, improvement of cerebral microcirculation and cerebroprotective action of this medication.
[The role of cytokine gene polymorphism in the formation of arterial hypertension associated with metabolic syndrome].
Rapoport SI, Krivoshey IV, Milanova SN … +4 more , Alferov PK, Zhernakova NI, Proshchaev KI, Churnosov MI
Klin Med (Mosk) · 2016 · PMID 30289218
We investigated the association of polymorphisms of genes tumor necrosis factors and their receptors (-308G/A TNFa, +250A/G Lta, +36 A/G TNFR1, +1663 A/G TNFR2) with the predisposition to the development of essential hyp...
We investigated the association of polymorphisms of genes tumor necrosis factors and their receptors (-308G/A TNFa, +250A/G Lta, +36 A/G TNFR1, +1663 A/G TNFR2) with the predisposition to the development of essential hypertension (EH) and the features of its clinical course in patients with metabolic syndrome. It has been demonstrated that the molecular genetic marker +36G TNFR1 (OR=1,25) is involved in the formation EH in individuals with metabolic syndrome. The risk of stage III EH in patients with metabolic syndrome is enhanced by genetic variants -308GA TNFa (OR=2,72), -308A TNFa (OR=2,72), +250G Lta (OR=1,80), and combinations thereof -308A TNFa with +1663G TNFR2 (OR=3,85), +250G Lta with +36G TNFR1 (OR=3,85), +250G Lta with +1663G TNFR2 (OR=3,85) while protective properties are inherent in -308GG TNFa (OR=0,32), +250AA Lta (OR=0,45), -308G TNFa (OR=0,37), +250A Lta (OR=0,56) and a combination of genetic markers -308GG TNFa with +250A Lta (OR=0,31), -308G TNFa with +250AA Lta (OR=0,39), -308G TNFa with +250A Lta (OR=0,31).
[Personified strategy for the correction of cardiometabolic risk factors in the alien population of the Arctic].
Petrov IM, Sholomov IF, Petrova YA … +2 more , Dorodneva EF, Medvedeva IV
Klin Med (Mosk) · 2016 · PMID 30289216
Aim. To estimate the efficacy and prognostic value of individual consulting in Far North inhabitants during a 5 year survey. Materials and methods. 125 patients with metabolic syndrome were included in the study (24.8% w...
Aim. To estimate the efficacy and prognostic value of individual consulting in Far North inhabitants during a 5 year survey. Materials and methods. 125 patients with metabolic syndrome were included in the study (24.8% women, 24.8% men, age median 45 years (39-48); p > 0.05). All the participants were divided into 2 groups dependence on the consulting frequency in the framework of the non-surgical body mass reduction programs (group 1 - single consulting, group 2 - repeated consultings in 12 months). Results. Individual consulting of patients with MS within 3 months after the onset of the study allowed the target body mass to be achieved in 50% of the patients in association with the reduction of atherogenic lipid fractions (p < 0,05), insulin resistance (p < 0,05), inflammation markers, hemostasis disorders markers (p < 0,05) and decrease in the number of patients with behavioral risk factors. Repeated educational module increased the relative probability 1,9 (95% CI 1,03-3,6) and odds ratio - 2.4 (95% CI 1,01-5,4) of body mass maintenance within 24 months and also reduced the risk of type 2 DM development (Cox's F-Test: F = 2,7; p = 0,041) and atherogenicity of lipid profile after 5 year observations. Conclusion. Our results proves the necessity of active utilization of educational modules at least as often as once a year. For the successful use of these modules based at outpatient facilities of the Far North it is necessary to include a dietologist in the staff of prophylactic departments which encounters difficulty under the modern funding mode.
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